Active NPI
Wayne L Brenneman, M.D.
- Internal Medicine Physician
- Muskegon, MI
National Provider Identifier
1346228913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301040651
- Practice address
- 1500 E Sherman Blvd
Muskegon, MI 49444-1849 - Phone
- (231) 727-5211
- Fax
- (231) 727-4571
- NPI assigned
- Jan 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301040651 | MI | Primary |
Addresses
Primary practice location
1500 E Sherman Blvd
Muskegon, MI 49444-1849
Mailing address
PO Box 1848
Muskegon, MI 49443-1848
Phone (231) 672-8753
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4556530 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nbrenneman28557@direct.trinity-health.org | Direct | Mercy Physician Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624492800000",
"number": "1346228913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1848",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494431848",
"telephone_number": "231-672-8753",
"fax_number": "231-672-4932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E SHERMAN BLVD",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494441849",
"telephone_number": "231-727-5211",
"fax_number": "231-727-4571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNEMAN",
"first_name": "WAYNE",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-04",
"last_updated": "2021-06-24",
"certification_date": "2021-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301040651",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4556530",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nbrenneman28557@direct.trinity-health.org",
"affiliation": "Y",
"endpointDescription": "Mercy Health Muskegon Direct Email address",
"affiliationName": "Mercy Physician Network",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "service location",
"address_1": "1500 E Sherman Blvd",
"city": "Muskegon",
"state": "MI",
"country_code": "US",
"postal_code": "494441849",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.